| Entity Name: | MIND-FULLY-YOURS RECOVERY & WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Aug 2024 (5 months ago) |
| Document Number: | L24000382469 |
| Address: | 977 SW COLLEGE PARK RD, PORT SAINT LUCIE, FL 34953 |
| Mail Address: | 977 SW COLLEGE PARK RD, PORT ST. LUCIE, FL 34953 UN |
| ZIP code: | 34953 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023844255 | 2024-09-13 | 2024-09-13 | 977 SW COLLEGE PARK RD, PORT ST LUCIE, FL, 349535869, US | 977 SW COLLEGE PARK RD, PORT ST LUCIE, FL, 349535869, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 305-336-2162 |
Authorized person
| Name | MAXINE REEVES DAVIS |
| Role | NURSE PRACTITIONER |
| Phone | 3053362162 |
Taxonomy
| Taxonomy Code | 163WP0808X - Psychiatric/Mental Health Registered Nurse |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REEVES DAVIS, MAXINE | Agent | 977 SW COLLEGE PARK RD, PORT ST. LUCIE, FL 34953 |
| Name | Role | Address |
|---|---|---|
| REEVES DAVIS, MAXINE | Manager | 977 SW COLLEGE PARK RD, PORT ST. LUCIE, FL 34953 UN |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-08-30 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
